HESI MED SURG 55 QUESTIONS ANSWERS 2018 RN V1

Guaiac Occult Test. What lab is most important? Platelet Count 2. Patient had BDP 3 months ago with dehydration. What would warrant the nurse immediate intervention? Positive Gastro Occult 3. A patient with Parkinson’s. “Freezes.” Pretends there is a crack on the floor and Carefully lifts leg and steps over. Confirm that this is the correct and effective technique. 4. Patient had Atrial Fibrillation and then AED was used. One minute later, Patient sudden goes in to ventricular Tachycardia. What should the nurse do? Administer Adenosine over 1-2 seconds IV 5. Heart failure acute exacerbation. How to Reduce Cardiac Workload? Bedside Commode 6. External Fixation Device- What should the nurse do first? Assess for peripheral pulse at the foot 7. COPD patient is experience shortness of breath. Pursed Lip Breathing 8. Client with CVA (stroke). Has only eaten half of their food. Family is concern about nutrition. What should the nurse tell the family? Demonstrate the use of Visual Scanning. 9. A male client with asthma has bronchoconstriction and mucous production due to exercising. What should the nurse do? Determine if the client is using an inhaler before exercising. 10. A client with liver abscess and drainage of abscess. Which lab value? White blood Cell Count 11. Suprapubic prostatectomy. Three-way catheter. Which assessment? Urine Leaking meatus 12. A client with ulcerative colitis. UAP report what finding? Stool with fatty streaks 13. Flank pain and acute pyelonephritis. Priority nursing action. Administer IV antibiotics. 14. Long-standing pulmonary infection. Assess for hypoxia. Select All That Apply. Breathing patterns, Check mentation, color of skin and nailbeds 15. Traction applied, but client is frustrated because client keeps calling nurse for help with repositioning. Use a trapeze bar. 16. Multiple Sclerosis and urinary retention. Self-Catheterization 17. Client works as a data desk job with Raynaud’s syndrome. What to do to prevent wrist injury? Space Heater 18. C.K.D. Lab to report. Potassium 6.5 19. Client withy Gullian Barre is not blinking. Administer Lubricant 20. Taking prednisone PO 5mg. What symptom? Rapid Weight Gain. 21. Succinylcholine. High Temperature. Ice Pack axillary 22. The nurse drops a sterile package of supplies on the floor in the operating room (OR) suite. The … impervious wrapper. Which action should the nurse implement? Open contents to sterile field package intact. 23. Client with Acute Glomerulonephritis. Restrict Sodium. 24. Client ask about biopsy results from cancer cells well differentiated. What response? Ask Healthcare provider to gather more information. 25. Right cataract and lens implant. Which intervention should the nurse first? Provide an eye shield to be worn while sleeping. 26. The unlicensed assistive personnel (UAP) reports to the nurse that a client who was admitted with abdominal pain has just had a large black tarry stool. What intervention should the nurse implement first? - Test the stool for occult blood. 27. Which action is most important for the nurse to implement to reduce the risk for deep vein thrombosis in a postoperative client? -Advise the client to perform leg exercises regularly. 28. The nurse is preparing a client for a bronchoscopy. While obtaining consent, the client complains of thirst and admits to drinking a small amount of orange juice two hours ago. What action should the nurse take? -Delay procedure for 6 hours. 29. A client uses triamcinolone (kenalog), a corticosteroid ointment, to manage pruritis caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. What action should the nurse implement? -Schedule an appointment for the client to the healthcare provider. 30. The nurse learns in change of shift report that the x-ray report for a newly admitted client indicates consolidation in the left lower lung. What action should the nurse take? -Administer a PRN dose of a bronchodilator. 31. The nurse is monitoring the glucose q4h of an adult woman admitted with DKA. Two hours after receiving 10 units of regular insulin for glucose of 255, the client is perspiring and complaining of shakiness. What intervention should the nurse implement? -Check Capillary glucose level. 32. The chest x-ray for a client who is admitted for pneumonia shows pleural effusion with decreased air flow in the entire left upper lobe. What breath sounds that verify the x-ray findings should the nurse document after auscultation of the left upper lobe? -Diminished breath sounds 33. Which food is most important for the nurse to encourage a male patient with osteomalacia to include in his daily diet? - Fortified milk and cereals. 34. An older adult woman is seen in the clinic 3 months following her diagnosis of type 2 diabetes mellitus (DM). She tells the nurse that she has had a difficult time keeping her blood sugar in control. The nurse reviews the client's current finger-stick and daily log of